Richard P Jackson

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT30106 Issued in FL

Practice address

9619 S Dixie Hwy
Miami, FL 33156-2804

Phone

(305) 722-0568

Fax

(305) 670-0899

NPI assigned

Feb 25, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinecrest Performance LLCGroup PAC ID 5092228239, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pinecrest Performance, LLC

  • Physical Therapy Clinic/Center
  • Miami, FL
  • NPI 1962126169

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Pinecrest Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Pinecrest, FL
  • NPI 1174607006
  Medicare reassignment NPD
• Pinecrest PT-South L.L.C.

  • Physical Therapy Clinic/Center
  • Miami, FL
  • NPI 1427562073

  Physical Therapist

  Medicare reassignment NPD
• Pinecrest Strength & Conditioning, L.L.C.

  • Physical Therapy Clinic/Center
  • Miami, FL
  • NPI 1962011221
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1053703215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 331933",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "332331933",
            "telephone_number": "305-722-0568",
            "fax_number": "305-670-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9619 S DIXIE HWY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562804",
            "telephone_number": "305-722-0568",
            "fax_number": "305-670-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RICHARD",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT30106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lewis Jackson Jr., M.D.
• Marie-Therese Jackson, PHARM.D.
• Melissa Jackson, M.D.
• Melody Felissa Jackson
• Meredeth McHugh Jackson, APRN
• Robert Mark Jackson, MD
• Rosemary Jackson, MD, MPH
• Salonika Jackson
• Shaniece Jackson
• Jacob Cohen MD PA

• Physical Therapist in Miami, FL
• Providers in Miami, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.